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  • Title: [Effects of intranasal midazolam premedication on inhaled induction of anesthesia with sevoflurane of pediatric patients].
    Author: Wang R, Wang WH.
    Journal: Zhonghua Yi Xue Za Zhi; 2016 Jun 28; 96(24):1907-11. PubMed ID: 27373358.
    Abstract:
    OBJECTIVE: To evaluate the effects of intranasal midazolam premedication on children who undergoing inhaled induction of anesthesia with sevoflurane. METHODS: One hundred American Society of Anesthesiologists(ASA)Ⅰ-Ⅱ children undergoing elective operations in Tianjin Medical University Cancer Institute and Hospital from June 2014 to June 2015 were randomly assigned into 2 groups, and 50 cases in each group. Patients received different intranasal premedication giving 30 min before anesthesia: midazolam 0.3 mg/kg (control group) and normal saline (placebo group) 2 ml. The following data were observed: the anxiety scores of the children in the preoperative interview (T1), before intranasal premedication (T2), during the induction room play (T3) and in the beginning of sevoflurane-inhaled induction (T4) using Modified Yale Preoperative Anxiety Scale (m-YPAS); the satisfaction scores of parents when children entering the operating room using Visual Analogue Scale (VAS); and the cooperation scores of the children receiving the sevoflurane-inhaled induction using Induction Compliance Checklist (ICC). The process of induction, the induction of sevoflurane and adverse incident were recorded. RESULTS: The scores of m-YPAS of the induction room play (T3) and in the beginning of sevoflurane-inhaled induction (T4) of the control group were (26.48±9.04) and (40.88±17.31)scores, while those of the placebo group were (32.38±10.67) and (56.50±20.02) scores. The m-YPAS scores of the control group were significantly lower than those of the placebo group (t=2.983, 4.173, all P<0.05). The VAS of the control group and placebo group were (6.55±1.55) and (8.18±1.46) scores, the VAS of the control group was significantly lower than that of the placebo group (t=5.504, P<0.05). The total time of induction of the control group was (84.35±22.47)s, which was significantly shorter than that of the placebo group((104.21±31.05)s, t=3.664, P<0.05). The scores of m-YPAS in the preoperative interview (T1), before intranasal premedication (T2), the scores of ICC, the time of closing eyes and excitement phase of 2 groups had no significant difference (all P>0.05). There was no adverse incident happened in both groups. CONCLUSIONS: Intranasal midazolam provided as premedication can reduce the anxiety for children undergoing inhaled induction of anesthesia with sevoflurane, and shorten the time of induction. It's a safe and effective method for premedication of pediatric anesthesia.
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